1. Field of the Invention
The present invention relates generally to the field of computer-implemented inventions, and more specifically, to a system and method for electronic medication administration records.
2. Description of the Related Art
Over the past ten years of service to long-term care (“LTC”) facilities, Emissary Professional Group, LLC d/b/a Emissary Pharmacy and Infusion—a “closed door” pharmacy providing contract medication services to patients in long term care institutions around the state of Wyoming—has seen a marked increase in medication errors. In fact, medication errors have reached dangerous levels in the LTC facilities that Emissary Pharmacy serves. This market is only a very small sampling of a much larger problem, and it is not just a Wyoming problem. Medication errors in LTC facilities are a national problem and are cited in multiple studies as the number one safety issue plaguing this industry today.
According to the Journal of the American Medical Association [1], medication errors as “preventable adverse events” are a leading cause of injury and death for both the ambulatory and institutionalized elderly patients in the United States today. Medication errors are the leading cause of emergency room visits and hospitalizations, with one out of every ten skilled nursing facility residents suffering a medication-related injury every day they are institutionalized. A recent study performed by the University of Massachusetts Medical School [2] reveals that seventy three percent (73%) of the most severe injuries, including internal bleeding and death, were preventable. Annual costs for injuries due to medication errors in the LTC setting now exceed 1.5 billion dollars and may be as high as 32.8 billion dollars [3].
Patient safety and the delivery of “high-value health care” have become top priority strategic plan initiatives for the Centers for Medicare Services (“CMS”) in Washington, D.C. [4]. One of the aims of high-value health care is to emphasize prevention and better support for quality care, including the improvement of medical records. Most skilled nursing facilities still depend on an antiquated system: paper-based charts and records, including the medication administration record (MAR), that are handwritten for each medication administration event for each resident receiving medications. Paper MARs are an inefficient process with no clearly defined work flow that places needless stress on nursing staff.
Paper MARs are not designed to reduce medication errors, and they have remained unchanged for decades. Illegible entries can result in medication administration mistakes; for example, a nurse might misread a handwritten note left by a doctor or colleague. Instructions about discontinuing a medication, or altering its dosage, might not be accurately recorded. If a medication pass is delayed when nursing staff are called on to meet an urgent resident need, the paper-based system makes it nearly impossible to ensure that the process resumes seamlessly from where it was discontinued when the caregiver was called away. The common practice of inserting a paperelip, bookmark, or even a drinking straw into the paper MAR during an interruption in the medication pass does not assure that it has resumed accurately.
Excluding wrong-time errors (i.e., an incident occurring as a result of medication being given outside of the time frame in which it was scheduled to be given), omission of an ordered medication is generally the most common type of drug administration error in the skilled nursing facility. According to a recent study by the Institute of Medicine [5], the most common medication administration errors include (i) omitting a prescribed medication (44.8% of total errors), (ii) administering an unauthorized medication (41.5% of total errors), (iii) administering the wrong dose (11% of total errors), and (iv) administering medication via the wrong route (2% of total errors). With so many possibilities for error, paper MARs are not sufficient to assure the accuracy of administration of any medication, especially in the LTC setting, where staffing is always an issue, and nurses are often distracted by the daily needs of the elderly population. Furthermore, the price paid for medication errors has become far too costly in both human terms and financial dollars for the practice to continue in its current form.
Accordingly, what is needed is a software program designed specifically for the LTC environment that reduces or eliminates the most common errors. Existing software programs are inadequate for the LTC environment. For one, no existing software designed to work in an acute care hospital is a complete solution for the LTC environment. In addition, the methods used to guide the healthcare provider and track medication administration lack the sophistication and flexibility to work effectively in the LTC environment. As a result, they are at best partial solutions. A further drawback to these systems is that they require an in-house server computer to archive an institution's data.
To satisfy the above needs and overcome the deficiencies of existing systems, the present invention provides a software program that visually identifies the patient, identifies the medication, and prevents the caregiver from inadvertently omitting a prescribed mediation or administering an unauthorized medication, the wrong dose, or the right medication via the wrong route. It is a further object of the present invention to provide nursing staff with an easy and efficient way to conduct daily medication passes, assuring that LTC facility residents receive the “five rights” of medication administration: right resident, right drug, right dose, right route of administration, and at the right time. Yet another object of the present invention is to provide an intuitive software program that requires no more than a few minutes of training for nursing staff to use. An additional object of the present invention is provide increased functionality at lower cost by eliminating all but absolutely necessary hardware requirements for institutions.
It is estimated that the successful deployment and use of the present invention will help LTC facilities redirect or save approximately $40,000 in annual labor costs that are currently wasted using paper-based MARs. In addition, it is estimated that more than 1,500 man hours in the average 100-bed skilled nursing facility can be redirected to patient care each year as a result of the use of the present invention. Simply stated, the present invention is designed to improve both medication pass efficiency and overall resident safety.